Limitation of therapeutic effort in patients hospitalized in departments of internal medicine
| Autor: | S. Gámez, L. García Olmos, Gerardo de Vega, Benjamín Herreros, R. García Caballero, D. Real de Asúa |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Retrospective cohort study General Medicine 030204 cardiovascular system & hematology medicine.disease Comorbidity Intensive care unit law.invention 03 medical and health sciences 0302 clinical medicine law Internal medicine Advanced dementia medicine Dementia Observational study In patient 030212 general & internal medicine Cardiopulmonary resuscitation business |
| Zdroj: | Revista Clínica Española (English Edition). 218:1-6 |
| ISSN: | 2254-8874 |
| Popis: | Introduction There is little information on the limitation of therapeutic effort (LTE) in patients admitted to hospital internal medicine units. Objectives To describe the indicated LTE regimens in the departments of internal medicine and the characteristics of the patients who undergo them. Patients and methods An observational, descriptive retrospective study was conducted on 4 hospitals of the Community of Madrid. The study collected demographic and comorbidity data and the LTE orders prescribed for all patients who died during a period of 6 months. Results The study included 382 patients with a mean age of 85 ± 10 years; 204 were women (53.4%) and 222 (58.1%) came from their homes. Some 51.1% of the patients were terminal, 43.2% had moderate to severe dementia, and 95.5% presented at least moderate comorbidity. Some type of LTE was performed in 318 patients (83.7%); the most common orders were “No cardiopulmonary resuscitation” (292 patients, 76.4%; 95% CI 72.1–80.8), “Do not use aggressive measures” (113 patients, 16.4%; 95% CI 13.7–19.4) and “Do not transfer to an intensive care unit” (102 cases, 14.8%; 95% CI 12.3–17.7). Some type of LTE was performed in 318 patients (83.7%); the most common orders were “No cardiopulmonary resuscitation” (292 patients, 76.4%; 95% CI 72.1–80.8), “Do not use aggressive measures” (113 patients, 16.4%; 95% CI 13.7–19.4) and “Do not transfer to an intensive care unit” (102 cases, 14.8%; 95% CI 12.3–17.7). Conclusions LTE is common among patients who die in Internal Medicine. The most widely used regimens were “No CPR” and the unspecific statement “Do not use aggressive measures”. The patients were elderly and had significant comorbidity, terminal illness and advanced dementia. |
| Databáze: | OpenAIRE |
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